Children and adolescents with parental mental illness (CAPRI) : prevalence, physical health, and social outcomes

Children and adolescents whose parents have mental illness (CAPRI) are a potentially vulnerable group. Previous studies showed that they are more likely to experience adverse mental health and social outcomes. However, studies investigating their physical health outcomes are scarce. Additionally, reliable estimates on the size of this group and their living conditions in contemporary Sweden is lacking. My thesis aimed to establish the prevalence of CAPRI in Sweden and to deepen our understanding of their physical health and living conditions. Five individual studies were conducted using linkage from various Swedish national registers. One of the studies was also conducted using data from English registers. In Study I, we estimated the prevalence of children and adolescents up to age 18 with parental mental illness in Sweden and determined the associations with various socioeconomic adversity. We found that around 9.5% of children had at least one parent with mental illness diagnosed within secondary care. The prevalence increased throughout the age and calendar year. These children were also more likely to experience a range of socioeconomic adversity, including having unemployed parents, being in a household that received social welfare benefits, or a household with the lowest income quintile. In Study II, we determined the associations between parental mental illness and the risk of childhood injury. We found that, overall, CAPRI had a higher risk of injuries compared to children without parental mental illness, especially during the first years of life. The increase in risk was slightly higher for children exposed to maternal, compared to paternal mental illness, and for rarer types of injuries (e.g., violence-related injuries) compared to more common types of injuries, such as falls. All types of parental mental illness were associated with higher risk, although the risk increase was slightly higher for more common mental disorders (e.g., depression and anxiety) compared to more serious mental illness (e.g., psychosis). In Study III, we determined the associations between parental mental illness and the risk of autoimmune diseases among the children. Parental mental illness was associated with a slight increase in the risk of autoimmune diseases in the offspring. However, the detailed picture was slightly more complicated. The highest risk was observed for type 1 diabetes among children exposed to maternal eating disorders. Additionally, exposure to parental common mental disorders was associated with a higher risk of juvenile arthritis, psoriasis, and type 1 diabetes. On the other hand, exposure to maternal psychosis and paternal alcohol/drug misuse was associated with a lower risk of coeliac disease and inflammatory bowel disease, respectively. In Study IV, we determined the associations between parental mental illness and the risk of childhood cancer, which is a relatively rare outcome. To increase statistical power, we pooled the estimates from Swedish and English national cohorts. Overall, we did not find enough evidence on the risk of cancer among CAPRI. However, results showed that maternal (but not paternal) psychosis was associated with a 25% reduced risk of childhood cancer, although confidence intervals for this estimation included the one and therefore this finding needs replication in larger studies. We also found borderline evidence of an increased risk associated with maternal alcohol/drug misuse, but no evidence of a change in risk associated with other types of parental mental illness. In Study V, we determined whether parental mental illness affected the likelihood of children being placed in out-of-home care and identified which factors might modify such likelihood. We found that CAPRI were more likely to be placed into out-of-home care, especially during the first years of life, compared to children without parental mental illness. While all types of mental illness diagnoses were associated with higher risk, the risk was particularly higher if the parents had a diagnosis of intellectual disability, alcohol/drug misuse, or non-affective psychosis, and if it was the mother who received the diagnosis compared to the father. CAPRI who also lived in lower socioeconomic positions were a subset with a particularly high likelihood of being placed in care outside of their homes. Overall, these findings showed that CAPRI are common in the contemporary Swedish population. They are more likely to experience adverse physical health outcomes, such as injuries and certain types of autoimmune diseases, but not cancer. They are also more likely to experience poor social outcomes, including socioeconomic adversity and being placed in out-of-home care. This information has important implications for services and public health. We need to maintain awareness of the circumstances in which children live and understand how best to support them and their families if we are to ensure their well-being and improve their life outcomes

Correction to: Severity of depression, anxious distress and the risk of type 2 diabetes - a population-based cohort study in Sweden

Abstract It was highlighted that the original article [1] contained an error in the flow chart in Fig. 1

Suicidal behaviours among health care workers in Sweden

This study aim to determine the risk of suicide and suicide attempts among health care workers in Sweden compared to general working populatio

Risk and predictors of out-of-home care placement among children and adolescents with parental mental illness : a population-based cohort study in Sweden (Study IV)

Here, we propose a nationwide population-based study on predictors of out-of-home care placement among children of mentally ill parents, using rich information from Swedish national health and administrative registers. We aim to clarify both individual-level factors (children and parents), such as type and timing of parental mental illness, background factors of parents and socioeconomic conditions of the family, and area-level factors, such as the county of residence that might play a role in determining out-of-home care placement among children with parental mental illness within the Swedish context. More specifically, we aim to answer the following questions: 1. What is the risk of out-of-home care placement among children with parental mental illness? Is the risk varied by age and sex of the child and type of maternal or paternal mental illness? 2. What are the risk factors that confers the highest risk of out-of-home care placement among children with parental mental illness?NoneManuscrip

Taktila farthinder för cyklister: effekter på hastighet och cyklisternas upplevelse

Rapporten är framtagen med ekonomiska bidrag från Trafikverkets Skyltfond. Ståndpunkter och slutsatser i rapporten reflekterar författaren och överensstämmer inte med nödvändighet med Trafikverkets ståndpunkter och slutsatser inom rapportens ämnesområden. För att minska risken för olyckor har vid många korsningspunkter genomförts åtgärder som ska sänka cyklisternas hastighet. En åtgärd som används i flera städer är taktila farthinder, till exempel ”rumble strips” eller gatstenar nedlagda tvärs över cykelvägen för att uppmärksamma cyklisten på korsande bil- eller gångtrafik. Effekten av taktila farthinder är dock dåligt utredd. Det är inte allmänt känt i vilken utsträckning de påverkar vare sig cyklisters hastighet eller övriga faktorer som uppmärksamhet, upplevd säkerhet och komfort. Dock kan ojämnt underlag i sig innebära en förhöjd olycksrisk. Syftet med projektet har varit att öka kunskapen om taktila farthinder för cyklister genom att undersöka i vilken utsträckning taktila farthinder minskar hastigheten hos cyklister samt hur cyklisterna subjektivt uppfattar taktila farthinder med avseende på upplevd säkerhet, komfort och uppmärksamhet på omgivningen. Detta har gjorts genom att utföra hastighetsmätningar vid korsningar med och utan taktila farthinder i Göteborg, samt genom intervjuer med cyklister. Hastighetsmätningarna utfördes vid sex mätplatser som parvis hade jämförbara förutsättningar. Cyklisters hastighet vid en mätplats med taktilt farthinder jämfördes med hastigheten vid en referensplats utan farthinder. Hastigheten uppmättes i två snitt per mätplats; ett strax innan farthindret (eller motsvarande position) samt ett på farthindret (eller motsvarande). Hastighetsmätningarna visar inget samband mellan farthinder och cyklisternas hastighet. Vid första mätplatsparet visar mätningarna att vid korsningen utan farthinder har cyklisterna både lägre medelhastighet samt större inbromsning än cyklisterna vid korsningen med farthinder. Resultatet från de två andra mätplatserna med referensplatser visar inte heller att farthindret skulle påverka cyklisternas hastighet. Resultatet från ett mätplatspar visar till och med en hastighetsökning i samband med farthindret.Drygt trettio cyklister intervjuades när de passerat ett taktilt farthinder på olika platser i centrala Göteborg. Omkring en tredjedel av de tillfrågade cyklisterna hade inte lagt märke till att de passerat ett farthinder. Omkring 80 procent av cyklisterna tyckte inte att farthinder får dem att sänka hastigheten. Majoriteten tyckte inte att det har någon påverkan på deras uppmärksamhet på övrig trafik, men hälften tyckte att det sänker deras komfort. Utifrån studiens resultat, rekommenderas att upphöra med användandet av taktila farthinder på cykelvägar i den form de i dagsläget används i Göteborgs Stad, till dess det finns ett större kunskapsunderlag att basera riktlinjer för utformning och användning på. Ytterligare studier med utökade hastighetsmätningar, före- och efterstudier samt observationsstudier rekommenderas i fler kommuner för att skapa en större kunskapsbas.Skyltfonde

Lifetime Musical Activities and Cognitive Function of the Elderly

Decreasing cognitive function of the elderly is one of the most common problems that might affect their quality of life. Music is an element that is  believed to be able to contribute to the quality of life of the elderly. However, whether musical activities that are done throughout the life span related to cognitive function is unclear. In this research, we evaluated the association between lifetime musical activities and cognitive function. Fifty three older adults from three nursing homes in East Jakarta were selected and interviewed regarding their characteristics and lifetime musical activities. Cognitive function was also measured using Mini Mental State Examinaion (MMSE). The results of this preliminary study revealed that a possibility of an association between lifetime musical activities and cognitive function of the elderly was indicated. The result also showed that the participants who were not actively involved in musical activities during their lifetime were twice more likely to develop cognitive function impairment than the elderly who were actively involved in musical activities, after being adjusted by the characteristics. These correlational results suggest the beneficial effect of musical activities throughout the life span on cognitive functioning for the elderly.Penurunan fungsi kognitif merupakan salah satu masalah umum pada lanjut usia yang mampu memengaruhi kualitas hidup mereka. Musik merupakan sebuah elemen yang dipercaya mampu berkontribusi terhadap kualitas hidup mereka. Meski demikian, hubungan antara aktivitas musikal yang dilakukan sepanjang hidup dan fungsi kognitif lansia belum diketahui secara pasti. Pada penelitian ini, hubungan antara aktivitas musikal sepanjang hidup dan fungsi kognitif dievaluasi. Lima puluh tiga lansia penghuni panti tresna werdha di Jakarta Timur dipilih dan diwawancarai terkait karakteristik dan aktivitas musikal sepanjang hidup mereka. Fungsi kognitif juga diukur menggunakan MMSE. Hasil penelitian ini menunjukkan adanya kemungkinan asosiasi antara aktivitas musikal sepanjang hidup dan fungsi kognitif lansia. Hasil penelitian juga menunjukkan bahwa partisipan yang tidak aktif melakukan aktivitas musikal sepanjang hidupnya dua kali lebih berpeluang untuk mengalami gangguan fungsi kognitif dibandingkan dengan mereka yang aktif melakukan aktivitas musikal, sete-lah disesuaikan dengan karakteristiknya. Hasil korelasi ini mengisyaratkan pengaruh bermanfaat dari aktivitas musikal sepanjang hidup terhadap fungsi kognitif lansia

Diagnoses of common mental disorders among social workers in Sweden : A register-based cohort study

Background: Little is known about common mental disorders (CMD) diagnoses among social workers, i.e., depression, anxiety, or stress-related disorders. This study aims to examine the risk of CMD among social workers in comparison to other workers and to further investigate differences between men and women and specific occupational titles. Methods: This register-based cohort study consists of 3,034,304 persons, of which 26,610 were social workers (0.9 % of all workers), aged 30 -64 years, living in Sweden in 2015. The risk of diagnosed CMDs was followed up until 2020. Cox regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI), adjusting for sex, birth country, education, and birth year. Results: The participants were followed up by a total of 16,833,742.9 person-years, with an average follow-up of 5.5 years. Social workers, compared to other workers, were at a higher risk of CMD (HR 1.3, 95 % CI 1.2 -1.4) after adjustment. The HR was equal, 1.3, for depression (95 % CI 1.2 -1.5) and anxiety or stress-related disorder (95 % CI 1.2 -1.4). The association between social work and CMD was stronger among men (HR 1.7, 95 % CI 1.6 -1.9) compared to women (HR 1.2, 95 % CI 1.1 -1.3). Further, men working as assistance analysts had the highest risk among the occupational categories (HR 2.2, 95 % CI 1.2 -3.9). Limitations: CMD diagnoses only included cases treated in secondary care. Conclusions: Social workers, especially male social workers, had a higher risk of CMD. This deserves attention for future research and interventions aimed at improving the mental health of social workers

Association between parental mental illness and autoimmune diseases in the offspring - A nationwide register-based cohort study in Sweden

Mental illness has been previously linked with autoimmune diseases, yet the associations between parental mental illness and offspring's risk of autoimmune diseases is largely unknown. We conducted a population-based cohort study of 2,192,490 Swedish children born between 1991 and 2011 and their parents to determine the associations between parental mental illness and risk of autoimmune diseases among the offspring. Time-dependent diagnoses of parental mental illness (psychosis, alcohol/drug misuse, depression, anxiety, eating disorders, personality disorders, attention deficit hyperactivity disorder, autism spectrum disorder) and offspring autoimmune diseases (type 1 diabetes (T1D), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus, psoriasis, multiple sclerosis, inflammatory bowel disease (IBD), coeliac disease) were identified from inpatient/outpatient healthcare visits. Associations were measured by hazard ratios (HRs) adjusted for potential confounders. Overall, parental mental illness was associated with a small increase in risk of offspring's autoimmune diseases (HR 1.05, 95% CI 1.02-1.08). However, parental common mental disorder (anxiety/depression) was associated with higher risk of JIA, psoriasis, and T1D (HR T1D 1.11, 95% CI 1.01-1.22), while maternal psychosis with reduced risk of coeliac disease (HR 0.68, 95% CI 0.49-0.95) and paternal alcohol/drug misuse with reduced risk of IBD (HR 0.80, 95% CI 0.64-0.99). Maternal eating disorders were associated with a markedly increased risk for T1D (HR 1.41, 95% CI 1.05-1.89). Further studies are needed to confirm these findings and to understand underlying mechanisms. There is a need for greater clinical awareness about potential risk of JIA, psoriasis, and T1D among children of parents with common psychiatric morbidity.</p